Dataset Information

Comparison of intentional and unintentional injuries among Chinese children and adolescents.

ABSTRACT: Background The patterns and risk factors of intentional injuries compared to unintentional injuries among Chinese children and adolescents have not been examined in depth. This work comprehensively describes patterns of intentional injuries in China, for which little information has been previously published.Methods All cases involving individuals 0-17 years old registered at emergency rooms and outpatient clinics were examined using data submitted to the National Injury Surveillance System from 2006 to 2017. A logistic regression model was performed to explore the risk factors related to intentional injuries compared to unintentional injuries.Results A total of 81459(95.1%) unintentional injuries, 4218 (4.9%) intentional injuries (4013 violent attacks and 205 self-mutilation/suicide) cases were identified. Blunt injuries accounted for 59.4% of violent attacks, while cuts and poisoning accounted for 37.1% and 23.4% of injuries involving self-mutilation/suicide, respectively. For unintentional injuries, falls (50.4%) ranked first. Additional risk factors for intentional injuries included being male [odds ratio (OR) =1.6], coming from rural areas (OR=1.9), being staff or workers (OR=2.2) and being a student (OR=1.8). As the age of the patients increased, so did the risk of intentional injuries (OR=5.0 in the 15-17 age group). Intentional injuries were more likely to occur at 00:00 - 03:00 am (OR=2.0).Conclusions Intentional injuries affected more males, rural and older children, school students and staff or workers. The mechanisms and occurrence times differed according to different age groups. Preventive measures should be taken to reduce the dropout of rural students, strengthen the school's violence prevention plan and reduce self-harm.

SUBMITTER: Yin X

PROVIDER: S-EPMC7661334 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Publications

Comparison of Intentional and Unintentional Injuries Among Chinese Children and Adolescents.

Yin Xiling X Li Deyun D Zhu Kejing K Liang Xiaodong X Peng Songxu S Tan Aijun A Du Yukai Y

Journal of epidemiology 20191109 12

<h4>Background</h4>The patterns and risk factors of intentional injuries compared to unintentional injuries among Chinese children and adolescents have not been examined in depth. This work comprehensively describes patterns of intentional injuries in China, for which little information has been previously published.<h4>Methods</h4>All cases involving individuals 0-17 years old registered at emergency rooms and outpatient clinics were examined using data submitted to the National Injury Surveill ...[more]

PMID: 31708510

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Project description:BackgroundCompared to other studies, the injury monitoring of Chinese children and adolescents has captured a low level of intentional injuries on account of self-harm/suicide and violent attacks. Intentional injuries in children and adolescents have not been apparent from the data. It is possible that there has been a misclassification of existing intentional injuries, and there is a lack of research literature on the misclassification of intentional injuries. This study aimed to discuss the feasibility of discriminating the intention of injury based on Machine Learning (ML) modelling and provided ideas for understanding whether there was a misclassification of intentional injuries.MethodsInformation entropy was used to determine the correlation between variables and the intention of injury, and Naive Bayes (NB), Decision Tree (DT), Random Forest (RF), Adaboost algorithms and Deep Neural Networks (DNN) were used to create an intention of injury discrimination model. The models were compared by comprehensively testing the discrimination effect to determine stability and consistency.ResultsFor the area under the ROC curve with different intentions of injuries, the NB model was 0.891, 0.880, and 0.897, respectively; the DT model was 0.870, 0.803, and 0.871, respectively; the RF model was 0.850, 0.809, and 0.845, respectively; the Adaboost model was 0.914, 0.846, and 0.914, respectively; the DNN model was 0.927, 0.835, and 0.934, respectively. In a comprehensive comparison of the five models, DNN and Adaboost models had higher values for the determination of the intention of injury. A discrimination of cases with unclear intentions of injury showed that on average, unintentional injuries, violent attacks, and self-harm/suicides accounted for 86.57%, 6.81%, and 6.62%, respectively.ConclusionIt was feasible to use the ML algorithm to determine the injury intention of children and adolescents. The research suggested that the DNN and Adaboost models had higher values for the determination of the intention of injury. This study could build a foundation for transforming the model into a tool for rapid diagnosis and excavating potential intentional injuries of children and adolescents by widely collecting the influencing factors, extracting the influence variables characteristically, reducing the complexity and improving the performance of the models in the future.

Project description:BackgroundAttention-deficit/hyperactivity disorder (ADHD) is often associated with other neurodevelopmental disorders (NDs) and with risky behaviors and adverse health outcomes, including injuries. Treatment with ADHD medication has been associated with reduced risk of injuries. However, it is unknown whether the association is present in individuals with co-occurring NDs. The aim of the present study was to estimate the association between ADHD medication use and unintentional injuries in Sweden in children and adolescents with ADHD, including those with co-occurring NDs.MethodsUsing a linkage of several national registers via the unique personal identification number, we identified individuals with a diagnosis of ADHD and of other NDs, including autism spectrum disorder, intellectual disability, communication disorders, learning disorders and motor disorders. The primary outcome was unintentional injuries. Secondary outcome was traumatic brain injury (TBI). Individuals were followed from January 1st 2006 or their 5th birthday or the date of the first unintentional injury, whichever came last, to December 31st 2013 or their 18th birthday or death, whichever came first. We compared the rate of injuries during periods on-treatment with the rate of injuries during periods off-treatment within the same individual using stratified Cox regression to calculate hazard ratio (HR) with 95% confidence intervals (CIs).ResultsFor children and adolescents with ADHD (N = 9,421) the rate of any unintentional injuries (HR = 0.85; 95% CI = 0.78-0.92) and TBIs (HR = 0.27; 95% CIs = 0.20-0.38) during medicated periods was lower than during non-medicated periods. Similar results were found among individuals with co-occurring NDs (N = 2,986), for unintentional injuries (HR = 0.88; 95% CI = 0.77-1.01) and for TBIs (HR = 0.27; 95% CI = 0.16-0.44).ConclusionsBeneficial effects of ADHD medication may extend beyond reduction of ADHD core symptoms to prevention of unintentional injuries in children and adolescents, including individuals with co-occurring NDs.

Project description:BackgroundImmigrants typically arrive in good health. This health benefit can decline as immigrants adopt behaviours similar to native-born populations. Risk of injury is low in immigrants but it is not known whether this changes with increasing time since migration. We sought to examine the association between duration of residence in Canada and risk of unintentional injury.MethodsPopulation-based cross-sectional study of children and youth 0 to 24 years in Ontario, Canada (2011-2012), using linked health and administrative databases. The main exposure was duration of Canadian residence (recent: 0-5 years, intermediate: 6-10 years, long-term: >10 years). The main outcome measure was unintentional injuries. Cause-specific injury risk by duration of residence was also evaluated. Poisson regression models estimated rate ratios (RR) for injuries.Results999951 immigrants were included with 24.2% recent and 26.4% intermediate immigrants. The annual crude injury rates per 100000 immigrants were 6831 emergency department visits, 151 hospitalizations, and 4 deaths. In adjusted models, recent immigrants had the lowest risk of injury and risk increased over time (RR 0.79; 95% CI 0.77, 0.81 recent immigrants, RR 0.90; 95% CI 0.88, 0.92 intermediate immigrants, versus long-term immigrants). Factors associated with injury included young age (0-4 years, RR 1.30; 95% CI 1.26, 1.34), male sex (RR 1.52; 95% CI 1.49, 1.55), and high income (RR 0.93; 95% CI 0.89, 0.96 quintile 1 versus 5). Longer duration of residence was associated with a higher risk of unintentional injuries for most causes except hot object/scald burns, machinery-related injuries, non-motor vehicle bicycle and pedestrian injuries. The risk of these latter injuries did not change significantly with increasing duration of residence in Canada. Risk of drowning was highest in recent immigrants.ConclusionsRisk of all-cause and most cause-specific unintentional injuries in immigrants rises with increasing time since migration. This indicates the need to develop strategies for maintaining the immigrant health advantage over time while balancing the desire to support integration, active living, and healthy child development.

Dataset Information

Comparison of intentional and unintentional injuries among Chinese children and adolescents.

Publications

Comparison of Intentional and Unintentional Injuries Among Chinese Children and Adolescents.

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